“Kevin, do you think those cats might have rabies?”
Calm and soft-spoken as usual, Kevin, a manager at LGHL, replied, “Yes…I think it’s very likely.”
Since the encounter, I immediately washed the wound and made a makeshift bandage out of a napkin. Sending a shudder down my spine was my next thought: I would have to get a shot.
Generally disliking shots, my main worry centered on my fear of dirty needles. Unfamiliar with local healthcare standards, what flashed through my mind was a series medical horror stories. New to this region, my fears stemmed from what little I’ve heard, with gaps filled in by my potentially rabies fueled imagination.
My head was flooded with images of an overcrowded waiting room filled with people with missing patches of skin, or tree limbs and pipes sticking out of heads—all managed by a tired triage nurse who would take a glimpse at my minute but festering scratch, slap a green tag onto my forehead, and sentence me to a 10 hour wait. By the time I saw a doctor, I would likely be the harbinger of a reenactment of 28 Days Later. Oh, and I almost forgot my innate fear of other peoples body fluids. My mind raced: body fluids…blood…disease…HIV/AIDS…death.
From media reports and publicity generated by NGO fundraising efforts, the continent of Africa is infamous for its very high rate of HIV/AIDs infection. While HIV rates are as high as 20% in some nations, Kenya has a comparably low rate of about 6% (whereas the US rate is less than a percent).
However, when I met with the doctor, my fears diminished as a poster described the use of post-exposure prophylaxis (PEP), a 28 day injection treatment aiming to prevent the HIV from infecting the body, was prominently displayed in the examination room. I felt assured that this clinic would be well aware of the dangers and methods of HIV transmission. After all, I was unaware that such a treatment even existed.
In fact, Kenya offers antiretroviral therapy for free. However, with a 40% unemployment rate, approximately half of Kenya’s 40 million people lives below the poverty line subsisting on less than $1.25 (PPP) a day. With so few resources, expenses surrounding laboratory fees or transportation to the medical facility can be prove to be harsh barriers for effective PEP implementation.
Once face to face with a doctor, I was particularly surprised that he made no attempt to rush me out of his small but clean office, as I was accustomed to the limited 15 minute face time typical with doctors back home. He took the time to explain the risk of rabies infection, treatment options, and even took the time to answer all my questions.
- Dog bites are the source of 99% of human rabies death.
- Incubation period for rabies is usually up to 90 days.
- Wound cleansing and vaccination within a few hours of contact can prevent the onset of rabies and death.
- Even if vaccinated, an after exposure shot should be given.
- While it is possible I could die from rabies, my death will certainly not be from cat born AIDS.
Going to a private clinic in Nakuru, Africa’s fastest growing town and the fourth largest city in Kenya, it should have been no surprise that the facilities would be rather modern. In some ways the experience was even superior to my previous doctor’s visits in the well-known, modern cities of Guangzhou and Hong Kong. The doctor’s office looked like it could have been a clinic that I could find back home; complete with cushioned examination tables, computers, and curtains. Incredibly, I felt quite at home.
Nonetheless, I carefully watched the nurse as she unwrap a fresh needle. After she was done, she walked toward the medical waste receptacle, but hung a right instead, stepped to open lid of the waste bin, and dropped my used needle in the trash can.
Okay, well, maybe not quite home.